糖尿病足患者细菌感染特征及其与下肢血管病变程度的关系

发布时间：2017-12-28 06:43

本文关键词：糖尿病足患者细菌感染特征及其与下肢血管病变程度的关系　出处：《中国现代药物应用》2016年19期 　论文类型：期刊论文

【摘要】：目的探讨糖尿病足患者细菌感染特征及其与下肢血管病变程度的关系。方法 80例糖尿病足伴细菌感染患者,依据泛大西洋学会联盟分级分为A、B、C、D四组,各20例。比较四组病原学特点、耐药情况及实验室相关检查指标的差异。结果 1四组患者踝-肱指数(ABI)、趾-肱指数(TBI)、中性粒细胞组间两两比较,差异均具有统计学意义(P0.05)。2 80例患者中,重度感染15例(18.75%),中度感染35例(43.75%),轻度感染30例(37.50%)。其中,重度感染患者中C、D级患者10例(66.67%),中度感染患者中C、D级患者23例(65.71%),轻度感染患者中C、D级患者16例(53.33%)。随着糖尿病足伴细菌感染患者血管病变程度的持续加重,其中度及以上感染患者比率也随之增加。依据药敏试验结果,产生抗生素耐药患者49例(61.25%)。3单一感染:革兰阳性菌感染占30.00%,革兰阴性菌感染占27.50%,真菌感染占5.00%,混合感染占37.50%。80例患者共培养出病原菌122株,排名前三位分别是金黄色葡萄球菌20株(16.39%),铜绿假单胞菌15株(12.30%),粪肠球菌9株(7.38%)。伴随糖尿病足伴细菌感染患者下肢血管病变程度的持续加重,其混合感染的比率也随之升高,其中D级患者中混合感染比率为66.67%。结论糖尿病足患者的下肢血管病变程度与混合感染之间明显相关,其下肢血管病变程度越严重,其混合感染几率越高,临床医师在治疗时应重视这一点。
[Abstract]:Objective to investigate the characteristics of bacterial infection in patients with diabetic foot and its relationship with the degree of vascular disease of lower extremity. Methods 80 patients with diabetic foot with bacterial infection were divided into four groups, A, B, C and D according to the pan the Atlantic Association classification, each 20 cases. The differences between the four groups of pathogenic characteristics, drug resistance and laboratory related examination indexes were compared. Results the difference of the ankle brachial index (ABI), the toe - humeral index (TBI) and the neutrophils group in the 1 four groups were all statistically significant (P0.05). Among the 280 patients, 15 cases (18.75%) were severe infection, 35 cases (43.75%) were moderate infection and 30 cases (37.50%) were mild infection. Among them, 10 cases (66.67%) of C and D were in severe infection, 23 cases (65.71%) were C and D in moderate infection patients, 16 cases (53.33%) were C and D in mild infection patients. With the continuous increase of the degree of vascular disease in patients with diabetic foot with bacterial infection, the ratio of the degree and above is also increased. According to the results of drug sensitivity test, 49 cases of antibiotic resistant patients (61.25%) were produced. 3 single infection: gram positive bacteria infection accounted for 30%, Gram-negative bacteria infection accounted for 27.50%, fungal infection 5%, mixed infection accounted for 37.50%. A total of 122 strains of pathogenic bacteria were co cultured in 80 patients. The top three were Staphylococcus aureus 20 (16.39%), Pseudomonas aeruginosa 15 (12.30%), and Enterococcus faecalis 9 (7.38%). The incidence of mixed infection increased with the aggravation of the degree of lower extremity vascular disease in patients with diabetic foot and bacterial infection, and the mixed infection rate in D patients was 66.67%. Conclusion the degree of lower extremity vascular disease is significantly correlated with mixed infection in diabetic foot patients. The more serious the lower extremity vascular lesion is, the higher the probability of mixed infection is. Clinicians should pay much attention to this when they are treated.
【作者单位】：河南省商丘市第一人民医院内分泌科;
【分类号】：R587.2
【正文快照】： 糖尿病足作为糖尿病患者最常见并发症之一,也是糖尿病患者接受住院治疗的最主要原因之一。糖尿病足的产生和感染、血管病变、神经系统之间密切相关,其可导致患者的足底生物力学特点发生变化,其临床症状包括缺血性静息痛、间歇性跛行、坏疽以及溃疡等[1]。糖尿病患者一旦并发糖

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